19827 77TH PL W.PDF111111111111
6549
19827 77TH PL W
NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of Edmonds does not warrant the
accuracy of anything set forth on these
map(s). Any person or entity requesting a
copy should conduct an independent
inquiry regarding the information shown on
the map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
employee-s or officers shall be liab-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS
CIVIC CENTER WATER -SEWER DEPARTMENT Caj] PP"Pect G-1107 when work
Is ready for Inspection. (No Insplec-
SIDE SEWER PERMIT tlons Saturday, Sunday or hotidsys.) N2 2210
ADDRESS
OWNER........ RQberl .............................................................. ...........
Permission is granted ... M .............. CONTRACTOR ..... ...................................
with CRY Sewers in aecor-_gy_ ---- a ............ ................ ig.6-7,-, for ........................ days to
dance with application On file and governin ordinances REPAIR or CONNECT a side sewer
9
ATTENTION IS CALiED TO THE: FOIJOWING:'
NOTE NO. 1—The owners of the Property may obtain a Permit to Construct sewer Inside Property line. A licensed Side Sewer Contrac, r mu I
be employed to construct side sewer In street area. Do not cover any Portion of sewer before it has been inspected.
NOTE No. 2--Obtain full Information regarding ordinan to
--Top of side sewer must have at least 30 inches coverage at property line and 12 Inches Inside property line; minimum grade of 2%.
NOTE No. 3 ce 11.16-030 and Regulations governing side sewers when you get PermIt.
No bends in grade sharper than 2A will be Permitted.
No. 4—Trenches in street must he water settled and surface of street restored to original condition. Contractors shall
failure due to Improper work which May develop within one year of completion. be responsible for
NOTE No. 5--'t Is unlawful to alter or do any other work than Is provided for in the Permit, or to do any work on the main sewer or its appur-
tenances except to insert the Pipe into the wye.
APPLICATION
STREET FILE for
The City of Edmonds SUDE SEWER PERMIT
NEW CONSTRUCTION [:] REPA-IRS
-7(AO
ILYNN PLANT
BASEMENT No . ..........................................
/0 1
OWNER ........... A/t ....... zl--C.3e� ... ...................... CONTRACTOR ... &6,G1.0 ....... ......................... ................... PERMIT No . ... ........
ADDRESS ... ...... W..��4644e 11115 LEGAL DESCRIPTION: LOT No. liliw ........ Ze� ........... BLOCK No—.-* ............... .....................
NAME OF ADDITION . .................................................................
b-
11,
40
0
0
APMROVED
AAY 1' 1961
7-
f
0
Approved:
�Jo
DATE............................ 13Y . ..... .... ...
The City of Edmonds Water Service Drawing EASEMENT NO . ........................................
NEW CONSTRUCTION REPAIRS JK LID NO . .................. ASMT. NO . ..................
OWNER................................................................................................ CONTRACTOR .......................................................... PERMIT NO . ....................
... ... ... . . ... .. . ........
JOB ADDRESS -15.S2,7 ............. 7.77'. . ..... P.L..-W ......... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
-902C HOWC44
A
T
PWW-0001 -11175 (REV. 11/78)
77 -rH PL. W, DATE MARr-4 .......................
U
0
U
0
F,
Z
0
ZD
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
STREET
A. eAddress or vicinity of Construction
19827 77 PL W Plat Ik' 262-069,1
0 Owner: Washington Natural Gas Co
Name
805 156 AV NE
Mailing Address
Bellevue, Washington 98007
City, S ta te, Zip Code
0 Contractor: Sarap At-; Above
Name
Mailing Address
City, State, Zip Code
Permit No.
Issue Date
FILE
0 Permit Issued To:
• Type of Work to be Done:
Install New Service
• Work in Connection With:
E) Sub or Plat R1 Single Family
El Comml. / Ind. El Apt. Condo.
• Pavement Cut: El Yes El No
State License Number
Telephone Number
** NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE **
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit mus le at for . . n purposes at all times.
ffpectio
I A
Signature:.L`7Z
. F A44-4 ?444F� ate
Owner or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Void after —days
Special Conditions:
Ammendments:-
Permit Fee:
Security Deposit:
Receipt No.: —
Fund III Fee:
Street Cut Dimensions
KI
N6 WORK TO BEGIN -PRIOR TO PERMITISSUANCE
Eng. Div. December 1978
FIELD INSPECTION NOTES (Fund 111 - Route conv to Street Dent.
rnmMn�n+- C -
Diagram:
Contractor called for inspection Yes NO
Work Disapproved By: Date: Bv: Date:
Work Approved By: —Date: __3
Inspector:
Encr. Div. December